Rx chains to roll out more nurse-in-a-box clinics

By Clark Howard | Your access to health care is getting easier in America today.

I’ve talked in the past about “nurse-in-a-box clinics” at retail storefronts that offer care 7 days a week from nurse practitioners.

BusinessWeek reports 16 of 50 states allow nurse practitioners to practice as primary care providers without restrictions. In the remaining states, the local affiliates of the American Medical Association have supported anti-competitive laws that restrict nurse practitioners. But there’s a strong movement in those states too to give pushback.

I can’t speak to the quality of clinincal care offered by nurse practitioners because I’m just an average guy with no training or knowledge. But a study by the Rand Corporation found zero evidence that they provide lesser care. The authors of another study were so impressed by nurse practitioners that they wanted to end the anti-competitive laws in a majority of states to better provide care for people.

The first law of being a doctor is do no harm. But these laws do harm. If you’re a physician and you think I’m wrong, go to Clark Stinks and tell me.

Meanwhile, some of the big pharmacy chains are looking to expand the number of nurse-in-a-box clinics they have on the ground. CVS is expanding from 600 clinics to 1,000 across the country. Walgreens plan to expand too.

A few years ago, everybody wanted in to this market space, but nobody knew the business model. So you had Wal-Mart boasting they’d have 2,000 clinics, but they fell flat on their face and haven’t figured out the business model yet. Ditto for Kroger too.

But the clinics are a natural outgrowth for the big pharmacy chains. So many people who don’t have a primary doctor come to their pharmacists looking for advice, essentially putting them in the difficult spot of being asked to practice medicine.

The nurse-in-a-boxes are a key solution to that problem, because in medical school, nobody wants to be a general practitioner, or a family practitioner, or a pediatrician. (All the income potential is in the specialties.) We need an alternate way to provide that care. And nurse practitioners are the unsung heroes of making it affordable in America.


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